This paper is one of four individual case study reports presenting the qualitative findings from a five-year investigation of the impact of accountability reform on students with disabilities in four states, eight districts, and twenty schools. This case study report presents qualitative data collected over a four-year period--2001-2004--from three levels of the public education systems, and provides an analysis of the impact of accountability reform on students with disabilities in one of the participating four states. This report is divided into five sections. Section I contains information regarding the methodology used to collect and analyze the state and local data presented in this report. Section II is an overview of the assessment and accountability systems in Maryland, including changes resulting from NCLB. In Section III the authors provide demographic information on each of the study sites. In Section IV they present their research findings at the state, district, and school level, and in Section V they present a discussion of the major findings for each embedded case study and address cross-site themes. (Contains 2 tables.)